Reduction in infarct size by ischemic preconditioning persists in a chronic rat model of myocardial ischemia-reperfusion injury.

Ischemic preconditioning (PC) has been consistently observed to reduce infarct size in models of regional myocardial ischemia. However, it is also known to render the heart resistant to injury for only a finite period of time (< 2 h). Myocardial adenosine is widely believed to be one of the mediators of PC and may produce myoprotection in part through an anti-neutrophil effect during the early reperfusion period. When infarct size is assessed following a relatively short period of reperfusion (< 3 h) PC hearts may appear protected although reperfusion injury in the myocardium may be ongoing. Thus, infarct expansion may occur as the effects of PC fade. To substantiate that PC produces a sustained reduction in myocardial necrosis, 27 male Sprague-Dawley rats were anesthetized with pentobarbital and instrumented for regional coronary occlusion (30 min) and reperfusion (7 days). Animals were randomized to a control group (n = 16) or PC (n = 11), which consisted of 2 cycles of 5 min of ischemia and 5 min of reperfusion immediately prior to coronary occlusion. Successful reperfusion was confirmed visually and the occluding suture was left in the chest during recovery. Seven days later, staining for risk area was made by the injection of Evans blue dye while the occluder was in place and necrosis was detected with triphenyltetrazolium chloride staining. Planimetry was performed by a blinded investigator who found the risk area to be 27.2 +/- 1.6 and 33.6 +/- 1.7% of the left ventricle (p = NS) in PC and controls, respectively. All hemodynamic measurements were comparable between groups at all times during ischemia and reperfusion. PC reduced infarct size from 43.3 +/- 2.0% of area at risk to 20.6 +/- -2.1%, a 48% reduction (p < 0.01), and eliminated transmural necrosis which was common in the control group. From these studies we conclude that ischemic PC results in a permanent reduction in infarct size rather than a transient reduction in infarct size in the context of a gradually evolving infarction due to reperfusion injury.

Pulmonary delivery of powders and solutions containing recombinant human granulocyte colony-stimulating factor (rhG-CSF) to the rabbit.

Two powder formulations (MMAD < 4 microns) containing rhG-CSF were insufflated (IF) via an endotracheal tube at doses of 5, 75 or 500 micrograms/kg to New Zealand white rabbits. Doses of 5 and 500 micrograms/kg of solutions were administered by intratracheal instillation (IT), subcutaneous (SC) injection in the thigh and intravenous injection (i.v.) via the marginal ear vein. Blood samples were removed at regular intervals from an indwelling jugular catheter. Blood was analyzed directly for total white blood cell counts (WBC). Plasma was assayed for rhG-CSF by a specific ELISA. The distribution of radioactive dose in lung tissue was found after administering Tc99m HSA in solution or when incorporated into powders. The pharmacokinetics and pharmacodynamics were determined for all routes of administration. High dose IV concentration vs. time profiles declined biexponentially (t1/2 alpha = 0.6 +/- 0.2 hrs, t 1/2 beta = 4.6 +/- 0.2 hrs, n = 8). Clearance was does dependent (11.6 +/- 2.6 [500 micrograms/kg, n = 8] vs; 21.8 +/- 3.3 ml/hr/kg [5 micrograms/kg, n = 5]). A normal systemic response was obtained after IF, indicating that rhG-CSF retains activity in the solid state. Dissolution and absorption of rhG-CSF from the powders were not rate limiting. The plasma concentration vs. time profiles peaked at similar times to those after IT (Tmax 1-2 hrs) but were earlier than obtained after SC (Tmax 6-10 hrs). Powders were less efficiently dosed to the lung lobes after insufflation compared with instillates (14.7 +/- 10.5 vs. 60.1 +/- 10.6%), resulting in bioavailabilities ranging from 5 to 33%.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibition of eicosanoids does not prevent neutrophil injury from phorbol in isolated rabbit lung.

Studies suggest that pulmonary and neutrophil cyclooxygenase and lipoxygenase products (i.e., eicosanoids) play a role in oxidant lung injury. We tested the hypothesis that such eicosanoids contribute to lung injury from activation of rabbit neutrophils by phorbol myristate acetate (PMA) in the pulmonary circulation of salt-perfused isolated rabbit lung preparations. We measured lung injury from PMA-activated neutrophils under zone 2 pulmonary vascular conditions with transvascular albumin flux by 125I-labeled albumin. We found that this flux was increased; catalase prevented the increase, confirming that the increase was from oxidant injury. However, results were inconsistent: about one-half of the preparations showed a marked increase and about one-half were not elevated. In preparations with a > 40-mmHg increase in pulmonary arterial pressure (Ppa), albumin flux increased, and in those with Ppa < 40 mmHg it did not. In those with Ppa > 40 mmHg, vascular volume, and presumably vascular surface area, was markedly reduced. We next studied PMA-activated neutrophils under zone 3 pulmonary vascular conditions in preparations with Ppa that increased < 40 mmHg. Albumin flux or filtration coefficient (Kf,c) was used to measure injury. Both were elevated. As with albumin flux, catalase prevented increases in Kf,c. BW-755C (a dual lipoxygenase and cyclooxygenase inhibitor) prevented increases in cyclooxygenase products and leukotriene B4 (a lipoxygenase product) but did not prevent increases in Kf,c. We conclude that a marked decrease in vascular volume can occur in zone 2 preparations and may mask the presence of injury as measured by transvascular albumin flux. A zone 3 vascular condition overcomes the vasoconstrictor-induced decrease in surface area and unmasks injury. Finally, oxidant injury from PMA-stimulated rabbit neutrophils in isolated rabbit lungs cannot be readily attributed to formation of eicosanoids.

Increase in filtration coefficient from actions of melittin on neutrophils in isolated rabbit lungs.

Activation of neutrophils may contribute to lung injury in the adult respiratory distress syndrome. We added rabbit neutrophils to the pulmonary circulation of salt-perfused and ventilated isolated rabbit lungs. These neutrophils were activated by adding synthetically pure melittin to the perfusate. This led to lung injury as measured by filtration coefficient under no-flow conditions. We also activated neutrophils in vitro before addition to the pulmonary circulation. These preactivated neutrophils also produced lung injury, indicating a primary action of melittin on neutrophils rather than on lung. The injury was prevented by aristolochic acid, which is an inhibitor of phospholipase A2 (PLA2), and independently by catalase, which is scavenger of hydrogen peroxide (H2O2). Aristolochic acid also appeared to act primarily on neutrophils since addition to neutrophils in vitro prevented injury from in vitro activation by melittin. Aristolochic acid did not appear to act as a free radical scavenger since it did not prevent injury from neutrophils activated by phorbol myristate acetate (PMA). PMA is a direct activator of protein kinase C in neutrophils and leads to formation of H2O2 with consequent lung injury. We conclude that activation of neutrophils by melittin leads to oxidant lung injury possibly from activation of PLA2. Since PLA2 does not directly produce a second messenger, such as diacylglycerol or inositol triphosphate, it is likely that other actions of PLA2 produce an intermediary mediator. We previously showed that an inhibitor of eicosanoid synthesis prevents lung injury from exogenous PLA2. This suggests that the formation of leukotriene B4 (LTB4), a 5-lipoxygenase product of arachidonic acid, may contribute to the oxidant lung injury from melittin.(ABSTRACT TRUNCATED AT 250 WORDS)

Pulmonary absorption of recombinant methionyl human granulocyte colony stimulating factor (r-huG-CSF) after intratracheal instillation to the hamster.

Recombinant methionyl human granulocyte colony stimulating factor (G-CSF), a molecule of 18.8 kDa, has been shown to induce a systemic response after delivery by aerosol. In this work, rate and extent of absorption as well as the response were determined after bolus administration of solutions by intratracheal instillation (IT). The protein was quantified using a specific ELISA and the biological response was assessed by monitoring the increase in numbers of circulating white blood cells (WBC). A dose-response curve was obtained after IT, subcutaneous injection (SC), and intracardiac injection (IC) of 100 microL of a nominal dose ranging from 1 to 1000 micrograms/kg G-CSF (n = 5). WBC numbers were determined 24 hr postadministration. Absorption and clearance kinetics were determined after IT and IC of 500 micrograms/kg protein over a 24-hr time period (n = 5). The response of the lung to G-CSF was monitored by WBC counts and differentials in lung lavage fluid. 73.6 +/- 10.5% (n = 7) of the IT dose reached the lung lobes. The response to single doses of G-CSF by IT or SC was similar, with WBC numbers increasing over 4x baseline at the higher doses. Absorption from the lung was rapid and did not follow first-order kinetics. Clearance after the IC dose was described by a biexponential equation (alpha = 1.41, beta = 0.24 hr-1). Peak serum levels were obtained approximately 1-2 hr after IT. The bioavailability was 45.9% of the administered dose and 62.0% of the dose reaching the lung lobes. These results indicate that G-CSF is rapidly absorbed from the lung.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of neutrophils and phospholipase A2 on transvascular albumin flux in isolated rabbit lungs.

In this study, addition of phospholipase A2 (PLA2) to salt-perfused isolated rabbit lungs containing rabbit polymorphonuclear leukocytes leads to an increase in pulmonary capillary permeability. We add 1.5 X 10(8) polymorphonuclear leukocytes to the perfusate. Next, indomethacin is added to the perfusate and 40 units of PLA2 are infused into the pulmonary arterial inflow of the lungs. At the end of the study, a lung sample is removed for measurement of transvascular albumin flux using I125-albumin as a measure of the permeability-surface area product. Control studies demonstrate no increase in transvascular albumin flux. Addition of a dual cyclooxygenase and lipoxygenase inhibitor, BW755C, to the perfusate prevents the increase in transvascular albumin flux. We conclude that PLA2 interacts with polymorphonuclear leukocytes to increase protein permeability. Since PLA2 can release endogenous arachidonic acid and platelet-activating factor from cells, this suggests that release of such products may contribute to an increase in pulmonary capillary permeability from polymorphonuclear leukocytes. The ability of BW755C to prevent the increase suggests the possibility that lipoxygenase products contribute.

Edema from cyclooxygenase products of endogenous arachidonic acid in isolated lung.

We infused A23187, a calcium ionophore, into the pulmonary circulation of dextran-salt-perfused isolated rabbit lungs to release endogenous arachidonic acid. This led to elevations in pulmonary arterial pressure and to pulmonary edema as measured by extravascular wet-to-dry weight ratios. The increase in pressure and edema was prevented by indomethacin, a cyclooxygenase enzyme inhibitor, and by 1-benzylimidazole, a selective inhibitor of thromboxane (Tx) A2 synthesis. Transvascular flux of 125I-albumin from vascular to extravascular spaces of the lung was not elevated by A23187 but was elevated by infusion of oleic acid, an agent known to produce permeability pulmonary edema. We confirmed that A23187 leads to elevations in cyclooxygenase products and that indomethacin and 1-benzylimidazole inhibit synthesis of all cyclooxygenase products and TxA2, respectively, by measuring perfusate levels of prostaglandin (PG) I2 as 6-ketoprostaglandin F1 alpha, PGE2, and PGF2 alpha and TxA2 as TxB2. We conclude that release of endogenous pulmonary arachidonic acid can lead to pulmonary edema from conversion of such arachidonic acid to cyclooxygenase products, most notably TxA2. This edema was most likely from a net hydrostatic accumulation of extravascular lung water with an unchanged permeability of the vascular space, since an index of permeability-surface area product (i.e., transvascular albumin flux) was not increased.

Cyclooxygenase products from endogenous arachidonic acid in isolated dog and rabbit lungs.

We infused various doses of A23187, a calcium ionophore, into the pulmonary circulation to release endogenous arachidonic acid (AA) in salt-perfused isolated dog and rabbit lungs. Levels of prostaglandin (PG) I2 (as 6-keto-PGF1 alpha), thromboxane A2 (TXA2) as TXB2, and PGF2 alpha but not levels of PGE2 were elevated. Levels of TXA2 were similar between dog and rabbit lungs but levels of PGI2 and PGF2 alpha were higher in dog than in rabbit lungs. However, this difference was not the same at all levels of TXA2. At lower levels of TXA2, the differences were greater and narrowed at higher levels of TXA2. This led to an overlap in the ratios of PGI2/TXA2 and PGF2 alpha/TXA2 between dog and rabbit lungs. We conclude that species differences exist in formation of cyclooxygenase products between dog and rabbit lungs. With respect to products, differences may be dependent on the level of products in response to an AA-releasing agent. This suggests that rabbit lungs can be more sensitive than dog lungs to formation of relatively greater amounts of TXA2. However, the ratios of PGI2/TXA2 and PGF2 alpha/TXA2 can be similar between these species as follows: (1) if there is a sufficient dose of AA-releasing stimulus, or (2) if there is a sufficient difference in doses of the stimulus, with the lower dose being applied to rabbit lungs. Speculatively, physiologic effects of cyclooxygenase products may be similar under these conditions despite the species differences.

Effects of A23187, exogenous phospholipase A2 and exogenous arachidonic acid on pulmonary vascular resistance in isolated rabbit lung.

The authors gave infusions of exogenous arachidonic acid (AA), exogenous phospholipase A2 (PLA2) or A23187 into the pulmonary circulation of isolated salt-perfused rabbit lungs. Exogenous PLA2 and A23187 are agents that release the AA that is usually in the lung (i.e., endogenous pulmonary AA). The exogenous AA or A23187 led to pulmonary cyclooxygenase enzyme conversion of exogenous and endogenous AA to thromboxane A2 (TXA2), as TXB2, and prostacyclin, as 6-keto-prostaglandin-F1 alpha, as well as to elevations in pulmonary vascular resistance (PVR). The elevations in PVR as well as the elevations in TXB2 and 6-keto-prostaglandin-F1 alpha were prevented by indomethacin, a cyclooxygenase enzyme inhibitor, and the elevations in TXB2 and PVR but not the elevations in 6-keto-prostaglandin-F1 alpha were prevented by 1-benzylimidazole, a selective inhibitor of thromboxane synthesis. Maximum elevations in PVR occurred from conversion of AA to less than maximum levels of TXA2. Exogenous PLA2 led to release of endogenous AA with conversion to prostacyclin. However, such release of endogenous AA by exogenous PLA2 did not lead to conversion to TXA2 or to elevations in PVR. The authors conclude that elevations in PVR that depend on conversion of AA to TXA2 are limited by factors other than the amount of TXA2 or the amount of AA that is potentially available for such conversion.(ABSTRACT TRUNCATED AT 250 WORDS)

cAMP levels from endogenous and exogenous arachidonic acid in isolated dog lung.

We infused exogenous arachidonic acid (AA) into salt-perfused isolated dog lungs. This led to elevations in adenosine 3',5'-cyclic monophosphate (cAMP) which were from conversion of the AA to cyclooxygenase products. The maximal levels of cAMP occurred at far less than maximal levels of cyclooxygenase products. Next, we infused A 23187 to release endogenous pulmonary AA. This led to elevations in cAMP that were from conversion of this endogenous AA to cyclooxygenase products. The level of these products was far less than maximal levels from exogenous AA. However, maximal levels of cAMP from conversion of endogenous AA were similar to maximal levels of cAMP from conversion of exogenous AA. We conclude that maximal levels of pulmonary cAMP from endogenous or exogenous AA are from conversion of the AA to far less than maximal levels of pulmonary cyclooxygenase products. This indicates that levels of cAMP rather than levels of cyclooxygenase products are a potential rate-limiting step in cAMP-linked pulmonary actions of such products from pulmonary conversion of endogenous or exogenous AA.

Distribution of cyclooxygenase products with cyclooxygenase inhibition in isolated dog lung.

Arachidonic acid metabolism can lead to synthesis of cyclooxygenase products in the lung as indicated by measurement of such products in the perfusate of isolated lungs perfused with a salt solution. However, a reduction in levels of cyclooxygenase products in the perfusate may not accurately reflect the inhibition of levels of such products as measured in lung parenchyma. We infused sodium arachidonate into the pulmonary circulation of isolated dog lungs perfused with a salt solution and measured parenchymal, as well as perfusate, levels of 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha), prostaglandin F2 alpha (PGF2 alpha), prostaglandin E2 (PGE2), and thromboxane B2 (TxB2). These studies were repeated with indomethacin (a cyclooxygenase enzyme inhibitor) in the perfusate. We found that indomethacin leads to a marked reduction in perfusate levels of PGF2 alpha, PGE2, 6-keto-PGF1 alpha, and TxB2, as well as a marked reduction in parenchymal levels of 6-keto-PGF1 alpha and TxB2 when parenchymal levels of PGF2 alpha and PGE2 are not reduced. We conclude that, with some cyclooxygenase products, a reduction in levels of these products in the perfusate of isolated lungs may not indicate inhibition of levels of these products in the lung parenchyma and that a reduction in one parenchymal product may not predict the reduction of other parenchymal products. It can be speculated that some of the physiological actions of indomethacin in isolated lungs may result from incomplete or selective inhibition of synthesis of pulmonary cyclooxygenase products.

Effect of oral administration of arachidonic acid on prostaglandin and zinc metabolism in plasma and small intestine of the rat.

The effect of different doses of arachidonic acid (AA) on the intestinal zinc transport rate and on the plasma and intestinal PGE2, PGF2 alpha and 6-keto-PGF1 alpha levels in rats were measured to determine whether the metabolism of AA is involved in the zinc transport mechanism. Twenty-four rats were divided into 4 groups of 6 rats. Each rat received either 1.0 ml of distilled water, 0.5 mg, 1.0 mg or 1.5 mg/ml of AA intraduodenally at 24 and 4 hours before sacrifice. One hour before sacrifice, each rat also received 10 micrograms of 65Zn intraduodenally. The zinc transport rate decreased in comparison to controls when 0.5 mg of AA was given to the rats, but increased when 1.0 mg or 1.5 mg of AA was given. The levels of PGE2, PGF2 alpha and 6-keto-PGF1 alpha (PGI2 metabolite) in the intestinal mucosa all decreased in proportion to the amount of AA given. However, in the plasma, only PGF2 alpha levels decreased while PGE2 and 6-keto-PGF1 alpha levels showed no change compared to controls. When rats were given 1.5 mg of AA without oral administration of 65Zn, plasma PGE2 levels increased while PGF2 alpha levels decreased. The results suggest that AA metabolism influences the zinc transport mechanism by modulating the relative levels of PGE2, PGF2 alpha and PGI2 in plasma and small intestine.

Inhibition of cyclooxygenase production does not prevent arachidonate from increasing extravascular lung water and albumin in an isolated dog lung.

We examined the hypothesis that arachidonic acid can lead to pulmonary edema, increased pulmonary vascular permeability, and increased pulmonary vascular resistance (PVR) in an isolated dog lung. The lung was perfused with a dextran-salt solution to remove blood elements. Compared to controls, 20 mg/min sodium arachidonate into the pulmonary circulation led to edema and to an increase in a permeability and surface area index (PSI%), PVR, and cyclooxygenase (i.e. prostaglandin) production as measured by 6-keto-PGF1 alpha, TXB2 and PGF2 alpha. With 20 mg/min arachidonate, indomethacin inhibited the increase in cyclooxygenase production, reduced the increase in PVR and increased the edema and PSI%. Indomethacin, alone, did not produce edema or an increase in PSI% or PVR. Lower doses of arachidonate (0.1 to 5 mg/min) led to increasing cyclooxygenase production without obvious edema or an increase in PSI% or PVR. We conclude: 1) arachidonate can lead to pulmonary edema and an increase in PVR, and may lead to an increase in pulmonary vascular permeability; these effects of arachidonate do not require normal numbers of circulating blood elements; 2) arachidonate appears to contribute to pulmonary edema and increased PSI% by a noncyclooxygenase effect since inhibition of cyclooxygenase production did not prevent, and lower doses of cyclooxygenase production did not produce edema or an increase in PSI%; 3) the increase in PVR appeared to have a cyclooxygenase component since inhibition of cyclooxygenase production reduced the increase, and 4) indomethacin can increase the magnitude of edema and PSI% from arachidonate by an undefined mechanism.

The effects of arachidonic acid, PGI2, and 6-keto-PGF1 alpha on cyclic nucleotide concentrations in a ventilated and artificially perfused isolated dog lung.

In 35 isolated dog lung preparations, the pulmonary circulation of the right lung was completely separated from that of the left so that 1 lung of each preparation could serve as a control. The lungs were ventilated with 14% O2, 6% CO2 and 80% N2 and the pulmonary circulations were perfused with a dextran-salt-bicarbonate solution containing theophylline. Samples of perfusate were assayed for cyclic AMP and cyclic GMP (radioimmunoassay). Infusions of arachidonic acid (n=6) and PGI2 (n=4) but not 6-keto-PGF1 alpha (n=3) into the pulmonary circulation led to increases in cyclic AMP compared to control. Cyclic GMP levels were unchanged by the various infusions. Indomethacin (n=4) and acetylsalicylic acid (n=4) (prostaglandin (PG) synthesis inhibitors), and tranylcypromine (n=4) (a PGI2 synthetase inhibitor), prevented the cyclic AMP increases from arachidonic acid. This prevention was not the result of interference with the ability of cells to produce or release cyclic AMP since indomethacin (n=3), acetylsalicylic acid (n=3), and tranylcypromine (n=4) did not prevent cyclic AMP increases from PGI2. We conclude that infusion of arachidonic acid into the canine lung elevated pulmonary cyclic AMP but not cyclic GMP; that part or all of this increase most likely resulted from conversion of arachidonic acid to products of PG synthesis, particularly PGI2; that infusion of PGI2 mimicked arachidonic acid in that pulmonary cyclic AMP but not cyclic GMP was elevated, and that 6-keto-PGF1 alpha, a metabolite of PGI2, is unlikely to account for the cyclic AMP increases in this study.